Pearly penile papules are small round bumps on the rim of the penis head.  Usually flesh-colored or a little lighter, many males who find them worry they have an STI. Despite their appearance, pearly penile papules are not a sexually transmitted infection. They are not cancerous or contagious, and they do not need to be removed for any medical reason. Often, pearly penile papules can appear and disappear naturally over time.

Those who feel self-conscious about having pearly penile papules might consider a removal procedure called “carbon dioxide laser ablation.”  However, many medical professionals do not recommend this treatment since it is not medically necessary. The procedure can also leave scarring or cause infection. Be sure to talk with your doctor in depth if you are considering having your pearly penile papules removed. Teen Clinic does not offer this service.

So in short—nope! You don’t need to do anything at all.  You are still safe and healthy. Talk with a provider at Teen Clinic if you want to brainstorm how to discuss this with partners.

…although we were not actually engaging in intercourse. What is this and is there a risk for pregnancy?

Great question!  The substance you’re referring to is called pre-ejaculate (also known as pre-cum). Pre-ejaculate is a clear, sticky fluid often released by the penis between arousal and ejaculation.  Some penises release little to no pre-ejaculate; others may release quite a bit.  Doctors believe the purpose of pre-ejaculate is to make the urethra and the vagina less acidic, allowing sperm to survive longer.

Although pre-ejaculate does not contain sperm when it is produced, it can pick up leftover sperm in the urethra. This means that pre-ejaculate can contain sperm when it leaves the body, creating a risk for pregnancy.  Pre-ejaculate can also transmit STIs. If you do decide to have intercourse, be sure to use condoms consistently, correctly, and every time. If you decide to abstain from intercourse, pregnancy is not a risk unless semen or pre-ejaculate actually touches the vagina.

It’s possible. The skin in the genital area is very sensitive, and may become tender from overuse.  However, make an appointment at Teen Clinic if you are still experiencing symptoms in a week. Unprotected sex can allow the transmission of STIs, including skin infections like herpes, HPV, and pubic lice, so it’s important to make sure you’re healthy.

Unprotected sex also carries a risk of pregnancy. No hormonal birth control method is 100% effective; use condoms consistently, correctly, and all the time!  You can get unlimited condoms for free at Teen Clinic; just walk in anytime we’re open!

Yes.  When a male is aroused, a clear fluid called pre-ejaculate can seep out the tip of the penis. While pre-ejaculate contains less sperm than semen, it can still contain sperm! This means there is a risk for pregnancy during vaginal sex even if the male does not ejaculate into the vagina.

Whether or not you’ve noticed pre-ejaculate on the tip of the penis, it’s important to use a condom correctly, consistently, and every time. Withdrawal methods do not prevent the transmission of sexually transmitted infections, and are very ineffective at preventing pregnancy. Make an appointment at Teen Clinic to learn more about hormonal birth control methods, which are more than 99% effective if used correctly.

Masturbation can cause slight redness (from the friction of rubbing), but it should not cause bumps.  It’s a good idea to see a medical provider for evaluation if your bumps are still present.  If you are not sexually active, you’ll want to provide your doctor with information about any lubricants you’re using (especially household items, like soaps or shampoos) and personal grooming habits (like shaving).  Your genital area could be responding to something besides the actual masturbation.  If you are sexually active, making an appointment is even more important, as bumps can be a sign of infection.

Any cuts in the genital area should be evaluated by a health care professional.  It’s possible your cuts are an unusual presentation of herpes.  Cuts can also occur during shaving, or when the penis accidentally catches in the zipper of a pair of pants.

No matter how they occurred, avoid sexual activity until the cuts are healed!  Remember, open sores or wounds in the genital area make it easier to spread sexually transmitted infections.  Schedule an appointment for the next Teen Clinic or call your primary care doctor to make sure the cuts don’t indicate a more serious problem.

The term you’re asking about may be flaccid. This word refers to something hanging loosely or lacking firmness.  In sexual health, penises that are not erect are described as flaccid.

According to the Center for Disease Control (CDC), the inside of the foreskin contains less keratin—a waxy coating that helps prevent infection—than other parts of the penis.  Because of this, it tears more easily during intercourse, providing an entry into the bloodstream for infections like HIV.  The foreskin also contains more of the cells HIV tends to target (Langerhans cells) and has been more easily infected by HIV than other parts of  the penis in laboratory studies.  Finally, there is evidence that the environment between the unretracted foreskin and the head of the penis allows viruses to survive longer, increasing the likelihood of transmission.

There is still debate among medical professionals as to the extent that circumcision should be used as a prevention method.  After all, plenty of circumcised men still get HIV!  Keep in mind that wearing a condom, talking to your partners, and getting tested will help protect you from HIV transmission whether you’re circumcised or not.

To learn more about the studies being done on circumcision and HIV, check out this fact sheet from the CDC.

I would like to know if pre-cum contains sperm that can lead to pregnancy, and what are the chances she could become pregnant? I have heard pre-cum contains no sperm.  If it does, how could me and her go about preventing a pregnancy?

The chances of your girlfriend becoming pregnant is low, but there is a risk. Studies have shown that pre-ejaculate (pre-cum) often contains sperm, though at much lower levels than ejaculatory fluid.  If you are still within five days of the intercourse, have your girlfriend come to Teen Clinic for emergency contraception. This hormonal pill may help reduce the risk of pregnancy by preventing ovulation and thickening the cervical mucus.

Some research, including the reproductive health manual Contraceptive Technology, suggests that pre-ejaculatory fluid itself does not contain sperm; rather, it picks up leftover sperm from a previous ejaculation, which is hidden within the folds of the urethral lining. The studies suggest that this leftover sperm can be cleared from the urethra by urinating after sex.

However, there’s still much research to be done! And there’s also no way of knowing whether sperm is still present in the urethra.  At Teen Clinic, we recommend you reduce the risk of pregnancy by using a condom during intercourse every time, beginning to end. And remember that we have condoms and other birth control methods available to both of you at no cost, available on a walk-in basis.

Your chances of causing retrograde ejaculation in this way are slim.  Retrograde ejaculation—a condition in which semen enters the bladder instead of exiting the body through the urethra during ejaculation—is normally not self-caused.  People who experience this problem have usually had bladder neck or prostate surgery, or suffer from nerve damage caused by medical conditions like diabetes or multiple sclerosis.  Retrograde ejaculation can also be a side effect of certain medications used to treat prostate enlargement, high blood pressure, or mood disorders.

If you are concerned you may have retrograde ejaculation now, it is important to see a doctor.  Symptoms include dry orgasms—orgasms in which you ejaculate little to no fluid out of your penis—and urine that is cloudy because it contains semen.  However, it’s healthy to remember that everyone’s body is different.  Some males ejaculate a lot of semen, and some ejaculate a little. Learn what’s normal for your body—and don’t be afraid to come talk to a Teen Clinic practitioner if you’re feeling anxious.  Discussing your body and sexuality is a healthy way to feel confident and comfortable with yourself!